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Related Experiment Video

Updated: Sep 2, 2025

Development of a Gaze-Contingent Display Framework Designed for Perceptual and Oculomotor Research with Simulated Central Vision Loss

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Using a Computerised Staircase and Incremental Optotype Sizes to Improve Visual Acuity Assessment Accuracy.

Anna O'Connor¹, Chloe King¹, Ashli Milling¹

¹University of Liverpool, GB.

The British and Irish Orthoptic Journal

|August 8, 2022

Summary

Computerized Kay Pictures visual acuity testing shows improved accuracy and reliability. This new method offers lower test-retest variability compared to traditional ETDRS and Kay Pictures tests.

Keywords:

Visual acuity test-retest variability vision tests

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Area of Science:

Ophthalmology
Optometry
Vision Science

Background:

Accurate visual acuity testing is crucial for diagnosis and management.
Test-retest variability impacts the reliability of visual acuity measurements.
Standardization, such as through computerized staircase methods, can improve accuracy.

Purpose of the Study:

To evaluate if a computerized near-continuous incremental optotype display and scoring improves test-retest variability.
To compare the test-retest variability of computerized Kay Pictures with standard ETDRS and Kay Pictures tests.

Main Methods:

A computerized three-up, one-down adaptive staircase methodology was employed.
Kay Picture optotypes were displayed on an LCD monitor.
Three visual acuity assessment methods (ETDRS, Kay Pictures, computerized Kay Pictures) were tested twice on 119 adults.

Main Results:

Computerized Kay Pictures demonstrated low test-retest variability (0.01 logMAR).
This method showed the smallest mean bias (0.01 logMAR) and narrowest limits of agreement.
Participants performed better with computerized Kay Pictures compared to standard Kay Pictures and ETDRS.

Conclusions:

Computerized Kay Pictures testing is reliable and repeatable, exhibiting lower test-retest variability than ETDRS and Kay Pictures.
This computerized approach offers a more accurate and consistent measure of visual acuity.